Clinical Profile and Outcome of Stroke in Elderly Patients versus Younger Patients

Background: National data on the clinical profile and outcomes of ischemic stroke in younger adults are still infrequent. Objectives: We aimed to analyze clinical characteristics and outcomes of young patients with first-ever ischemic stroke compared to older patients. Patients and methods: A prospective cohort study in which Patients 51–84 years of age were compared with younger persons 50 years of age and under in terms of risk factors, clinical presentation, severity, etiology, and outcomes of stroke. For every age group, a logistic model was constructed to predict stroke outcomes. Results: Among patients 50 years of age and under, 146 cases of first-ever ischemic stroke were identified, while 854 cases were people 51–84 years of age. Younger individuals were 49.5% male, 47.3% currently smoked, and 7.4% had a history of stroke in their family. They more likely to arrive at the hospital independently and tended to appear with less frequent stroke symptoms, such headaches or sensory abnormalities. The majority of young adults (69.9%) had a favorable outcome (mRS ≤ 1) and 18% had an in-hospital complication Conclusion: Our findings demonstrate the relatively high rate of smoking and family history of stroke, and the lower rate of hospital arrival by ambulance among young adults. This calls for increasing awareness of the possibility of stroke among young adults and for better prevention, especially smoking cessation

Post-COVID-19 Electrophysiological, Cognitive and Psychological Assessment in a Sample of Healthcare Providers in Qena Governorate

Background: The COVID-19 outbreak threatens society globally. Stress and depression are common. Electrophysiological, cognitive, psychological, and covid-19 disease assessments Objectives: Assessment relationship between cognition, psychological and covid-19 disease. Patients and methods: 30 patients had covid-19-positive PCR, and 25 healthy controls matched for Sex and Age. Electroencephalogram (EEG) assessed electrophysiological changes, cognitive functions were assessed using Trail Making Test (parts A and B) and Montreal Cognitive Assessment (MoCA), depression and anxiety were assessed using HAM D & A. Results: No EEG changes after 1 month between cases and controls (p-value=0.099) and after 3 months (p-value=0.293).Follow, neither cases nor controls has EEG changes(p-value=0.630,1.0).Cases and controls differ in trail A(p-value=0.003) after month while after 3 months(p-value=0.123). In the cases, trail A after 1 month is different from trail A after 3 months(p-value=0.001). In controls, trail A after 1 month and 3 months is identical(p-value=0.428). Trail B shows no significant difference between cases and controls after 1 and 3 months(p-value=0.170,0.428) Cases and controls differ in 1-month MoCA(p-value=0.001). Cases and controls have similar MoCA after 3 months (p-value=0.917). Repeat MoCA after 3 months differs statistically(p-value=0.001,0.896). HAM-A statistically differs between cases and controls after 1 month(p-value=0.005), but not after 3 months(p-value=0.133). Cases and controls differ for HAM A within 1 month and after 3 months (p-value=0.001,0.048). After 1 month, HAM D cases and controls differ (p-value=0.249,0.753).follow cases and controls identical (p-value=0.006,0.188) Conclusion: Our study shows that SARS-CoV-2 impairs healthcare workers cognition and psyche

Brain Volumetric Abnormalities, Cognitive and Psychological Profile of Patients with Conversion Neurological Symptoms

Background: Functional neurological disorder (FND) causes motor or sensory symptoms without a neurological cause, leading to disability and distress. Neuroimaging shows structural brain changes in regions linked to pain and emotional regulation. Objectives: This study examines brain volumetric differences between FND patients and healthy controls, focusing on areas involved in emotion regulation and motor control. Patients and methods: The study included 50 FND patients and 40 healthy controls. Cognitive assessments used the Trail Making Test (TMT) A and B and the Montreal Cognitive Assessment (MoCA). Brain volumetric analyses were performed using the VolBrain tool on sagittal T1-weighted MRI scans. Data were analyzed using SPSS version 24. Results: FND patients had higher TMT-A (45.8 vs. 27.1, p < 0.001) and TMT-B (68.3 vs. 40.5, p < 0.001) scores, and lower MoCA scores (19.4 vs. 24.3, p < 0.001). Brain volumetry revealed decreased white matter (415.9 vs. 551.3, p < 0.001) and brainstem volumes (21.1 vs. 24.5, p < 0.001). Significant correlations were found between cognitive test scores and brain volumes. Conclusions: Significant brain volumetric differences were found between FND patients and healthy controls, particularly in white matter and brainstem volumes. These structural abnormalities are linked to cognitive impairments in FND patients, emphasizing the need for integrated diagnostic and therapeutic approaches. Further research is needed to understand the mechanisms underlying FND

Post Stroke Fatigue; Frequency, Risk Factors, Radiological Topographic Localization and Impact on Quality of Life

Background: Stroke, a leading global cause of death, categorized as ischemic or hemorrhagic. Post-stroke fatigue (PSF) is common, impacting quality of life, rehabilitation, and survival, with hypertension and diabetes as contributing comorbidities. Identifying risk factors is complex due to the multifaceted nature of fatigue. Objectives: Examine factors affecting PSF, disease frequency, and its impact on patient recovery and quality of life, focusing on Upper Egypt. Patients and methods: Study involved stroke-fatigued 200 patients and 129 stroke patients without fatigue, at Qena University Hospital. Age ranged from 16 to 75, with a 3-month follow-up within a year after stroke onset. Assessments included demographics, risk factors, stroke severity (NIHSS), cognitive function (MoCA, Mini-Mental), insomnia symptoms (ATHENS), functional outcomes (Modified Rankin Scale, Barthel Index), depression and anxiety severity (Hamilton scales), fatigue (MFI), and overall quality of life (WHOQOL-BREF). Results: Post-stroke fatigue linked to worse cognitive scores, severe stroke symptoms (higher NIHSS), more disability (Modified Rankin), higher fatigue (MFI), and slighter quality of life (WHQOOL). Depressive and anxiety scores were higher in fatigued patients (Hamilton). Male gender, education negatively correlated with fatigue (P < 0.05). No major correlations with age, rural areas, marital status, comorbidities. Conclusion: Weariness is strongly linked to cognitive impairment in stroke patients. Higher NIHSS stroke severity is connected to fatigue, emphasizing stroke care. Fatigue impairs functional measures like the Modified Rankin Scale but not daily living (Barthel Index). Physical and environmental variables affect fatigue and quality of life. Post-stroke fatigue is caused by cognitive issues, stroke severity, and functional limitations

Bioinspired Physico‐Chemical Surface Modifications for the Development of Advanced Retentive Systems

A major aspiration in advanced materials is to create artificial adhesive surfaces for wearable medical devices to meet the demands of the body's challenging settings and dynamics. For instance, dentures replace missing teeth and operate within the oral cavity, where an interplay between forces, muscles, saliva, and roughness of mucosa undermine their ability to grip oral tissues. Consequently, the lack of effective retentive strategies represents a source of dissatisfaction for denture wearers globally. Nature is rich in examples that employ physical and chemical adhesive strategies to optimize interfacial forces in dry and wet environments. Here, keratin‐coated octopus‐like suction cups are presented at the micro‐ and macroscale to improve the retention of rigid poly(methyl methacrylate). Microtopographies are obtained using two‐photon polymerization and maskless lithography, while denture prototypes with macrotopographies are derived via digital light processing 3D printing. Results suggest that microtopographies and keratin‐coated surfaces sustain higher maximum adhesion stress than the non‐topographical and non‐coated surfaces in moist environments, where retention is typically lacking. Proof‐of‐concept dentures demonstrate higher maximum detachment forces than conventional dentures with and without denture adhesive within dry and wet environments. This interdisciplinary research highlights the potential application of a nature‐inspired physico‐chemical approach in the next generation of complete dentures

Biomimetic supramolecular protein matrix restores structure and properties of human dental enamel

Tooth enamel is characterised by an intricate hierarchical organization of apatite nanocrystals that bestows high stiffness, hardness, and fracture toughness. However, enamel does not possess the ability to regenerate, and achieving the artificial restoration of its microstructure and mechanical properties in clinical settings has proven challenging. To tackle this issue, we engineer a tuneable and resilient supramolecular matrix based on elastin-like recombinamers (ELRs) that imitates the structure and function of the enamel-developing matrix. When applied as a coating on the surface of teeth exhibiting different levels of erosion, the matrix is stable and can trigger epitaxial growth of apatite nanocrystals, recreating the microarchitecture of the different anatomical regions of enamel and restoring the mechanical properties. The study demonstrates the translational potential of our mineralising technology for treating loss of enamel in clinical settings such as the treatment of enamel erosion and dental hypersensitivity

LncRNA ILF3AS1, MMP3, and MMP9 as well as miRNA-212 as emerging novel biomarkers for childhood epilepsy

BackgroundGlobally, approximately 70 million people suffer from epilepsy. Infants constitute a significant percentage of these cases. Hence, there is a significant need for better understanding of the pathophysiology of epilepsy through laboratory and radiological methods for early detection and optimized management. Interleukin enhancer binding factor 3 antisense RNA l (ILF3AS1) is a long non-coding RNA (lncRNA) that enhances the expressions of matrix metalloproteinase 3 (MMP3) and matrix metalloproteinase 9 (MMP9), which are considered to be epileptogenic.AimWe aimed to assess the serum expressions of the lncRNAs ILF3AS1, MMP3, and MMP9 along with microRNA-212 (miRNA-212) as predictive biomarkers in children with epilepsy; we also assessed their correlations with magnetic resonance imaging (MRI) findings.Subjects and MethodsFifty children with epilepsy and fifty healthy controls were considered in this study. Serum expressions of the lncRNA ILF3AS1 and miRNA-212 were estimated by quantitative real-time polymerase chain reaction (qPCR). Serum concentrations of MMP3 and MMP9 were estimated by enzyme-linked immunosorbent assay (ELISA) in parallel with MRI findings and different baseline biochemical parameters of all the subjects.ResultsThe results showed significantly higher levels of lncRNAs ILF3AS1, MMP3, and MMP9 as well as lower levels of miRNA-212 in children with epilepsy compared to the controls. The fold-change of miRNA-212 was a significant negative predictor (odds ratio = 0.153, p = 0.000). The receiver operating characteristic curves (Roc) showed that the areas under the curves for MMP3, MMP9, and lncRNA ILF3AS1 as well as the fold-change for miRNA-212 were 0.659, 0.738, 0.656, and 0.965, respectively. Brain lesions were detected in 15 patients (30%) with epilepsy, whereas the remaining 35 patients (70%) had normal results.ConclusionSerum levels of the lncRNA ILF3AS1 among children with epilepsy were higher than those in the control group and were associated with upregulation of both MMP3 and MMP9 as well as downregulation of miRNA-212 expressions, suggesting their predictive utility in monitoring the development of epilepsy; this also means that a treatment plan focusing on the ILF3AS1/miRNA-212/MMP3/MMP9 axis could be an effective strategy for treating epilepsy